Individual
ROXANNE DAWN STACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
8945 N TIMOTHY LN, FOUNTAINTOWN, IN 46130-9703
(317) 847-9082
Mailing address
8945 N TIMOTHY LN, FOUNTAINTOWN, IN 46130-9703
(317) 847-9082
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06003123A
IN
Other
Enumeration date
08/23/2008
Last updated
08/23/2008
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